Unity Hospital, an affiliate hospital of Rochester Regional Health, is a 287-bed community hospital in Greece, New York. After a four-year renovation in 2014, Unity is now the only Monroe County hospital to feature all private patient rooms and free parking. Unity offers a broad range of specialty centers, including the Golisano Restorative Neurology & Rehabilitation Center; the Charles J. August Joint Replacement Center and the August Family Birth Place. The hospital is also a New York State-designated Stroke Center.
Pulmonary arterial hypertension is a rare group of diseases with distinct etiologies affecting all ages, with predominant prevalence in young women. The key common aspect of the disease process is pulmonary arterial remodeling and vasoconstriction, leading to right heart failure. The symptoms most commonly manifest as shortness of breath and progressively worsening exercise intolerance. Early diagnosis, identification of the underlying cause, and targeted treatments aimed at mitigating right heart failure are crucial in management. Although new therapies have emerged recently, it is still a condition with high morbidity and mortality that requires specialized multidisciplinary care. The aim of this study is to review the current literature on key aspects of pulmonary arterial hypertension.
e19066 Background: Patients with diffuse large B-cell lymphoma (DLBCL) are highly vulnerable to infectious complications due to disease-related immune dysfunction and immunosuppressive therapies. The impact of coronavirus disease 2019 (COVID-19) on short- and long-term outcomes in patients with DLBCL remains incompletely characterized in large real-world populations. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, including adult patients (≥18 years) with a diagnosis of DLBCL. Patients were stratified into two cohorts based on the presence or absence of COVID-19 infection. Propensity score matching (1:1) was performed for demographics and major comorbidities. The primary outcome was all-cause mortality. Secondary outcomes included acute respiratory failure, mechanical ventilation, and other COVID-related complications. Outcomes were assessed at 30 days, 90 days, and up to 3 years following the index event using risk ratios and Kaplan–Meier survival analyses. Results: After propensity score matching, 33,026 patients were included in each cohort. Patients with DLBCL and COVID-19 demonstrated significantly higher 30-day mortality compared with those without COVID-19 (22.4% vs 18.5%; risk ratio [RR] 1.21, 95% CI 1.18–1.25; p <0.0001). Over long-term follow-up, COVID-19 infection was associated with worse overall survival, with a significantly increased hazard of mortality on Kaplan–Meier analysis (hazard ratio [HR] 1.97, 95% CI 1.86–2.09; p <0.0001). Additionally, patients with COVID-19 had a markedly higher incidence of acute respiratory failure at 3 years compared with those without COVID-19 (12.9% vs 5.1%; RR 2.52, 95% CI 2.39–2.67; p <0.0001). Conclusions: In this large real-world cohort, COVID-19 infection in patients with DLBCL was associated with significantly increased short-term mortality, worse long-term survival, and substantially higher rates of acute respiratory failure. These findings highlight the profound impact of COVID-19 on outcomes in patients with aggressive lymphoma and underscore the importance of preventive strategies and close monitoring in this high-risk population.
Objective: Papillary immature metaplasia (PIM) of the uterine cervix is an uncommon low-grade exophytic papillary squamous intraepithelial lesion characterized by immature metaplastic morphology. It typically involves the proximal transformation zone, often extending into the endocervical canal, and has been reported almost exclusively in premenopausal women. PIM is poorly recognized, partly because it is not included as a distinct entity in the current WHO classification of tumors. Because of its proximal location, papillary architecture, and morphologic immaturity, PIM can pose significant diagnostic challenges, particularly in postmenopausal patients. Methods: Three cases of PIM occurring in postmenopausal women were described, and a review of the literature was performed. Key findings: All three cases showed typical histopathologic features of PIM; notably, two patients presented with postmenopausal bleeding and underwent repeated endometrial sampling. Among these three cases, only one case tested positive for low-risk HPV infection based on the available testing panels. Immunohistochemically, all three lesions showed diffuse GATA3 expression, suggesting its potential utility as an adjunctive marker for PIM. Review of literature shows it occurs almost exclusively in premenopausal women presenting with abnormal screening cytology or a cervical mass. Most cases (77%) are associated with low-risk HPV, predominantly types 6 and 11, and demonstrate a low Ki-67 proliferation index. Conclusion: PIM is a poorly recognized, low-grade papillary proliferative lesion of the uterine cervix associated with low-risk HPV infection. We report three cases of PIM in postmenopausal patients to increase awareness and improve recognition of this entity, thereby helping prevent both overdiagnosis and underdiagnosis.
